Objective: To describe the practice patterns at University of Miami (UM), short term outcomes and health disparities among ethnic groups.

Background: Deep brain stimulation (DBS) has been shown to improve quality of life in Parkinson’s disease (PD) patients. However, few studies have examined referral patterns for deep brain stimulation (DBS) patients from multi-ethnic communities.   

Methods: Retrospective chart review from the University of Miami DBS referred patients.

Results: 195 patients have been referred for DBS surgery for PD at the UM from January 2014 to January 2016. After multidisciplinary team evaluation, 54 patients (28%) underwent BL STN DBS (n=49) or GPI DBS (n=5). The mean age at the time of referral was 66 years (+/-15). 61,2% patients were white, 35,1 % Hispanic and 3.7% African American. The mean MDS-UPDRS score pre-DBS off medications was 48 (+/-16). At 12 months after the surgery the motor score improved 62.5% (DBS ON, MEDS ON= 18+/-7) With DBS ON, meds OFF mean MDS UPDRS was 23 +/- 8 (52% improvement). Patients also reported an overall decrease in levodopa equivalent daily dose (LEDD) from 999 (+/-461) to 633 (+/-331, 37% reduction). Surgical complications included 1 infection and 1 lead edema.

Conclusions: Despite the majority Hispanic and African American population in Miami, the referral pattern in this city includes mostly the white population illustrating the health care disparities among these ethnic groups. The disparity may be explained by poor access to movement disorders specialists in Hispanic and African American communities.  All patients demonstrated significant improvement in motor UPDRS and a significant decrease in medication after DBS regardless of ethnic group. Efforts should be made ​​to increase the access to DBS procedure among the Hispanic and African American population.

References: 1.         Willis AW, Schootman M, Kung N, Wang X-Y, Perlmutter JS, Racette BA. Disparities in deep brain stimulation surgery among insured elders with Parkinson disease. Neurology. 2014 Jan 14;82(2):163–71.

2.         Di Luca DG, Velez-Aldahondo VA, Jermakowicks W, Segala L, Moore HP, Singer C, Levin B, Jagid J, Luca CC. Deep Brain Stimulation for Parkinson’s disease: Short-term outcomes, referral patterns and health disparities. Poster session to be presented at the MDS-PAS 1st Pan American Parkinson’s Disease and Movement Disorders Congress; 2017 Feb 24-26; Miami, Fl.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-for-parkinsons-disease-short-term-outcomes-referral-patterns-and-health-disparities/